A microfluidic device for real-time on-demand intravenous oxygen delivery.
A microfluidic device for real-time on-demand intravenous oxygen delivery.
复制标题
一种用于实时按需静脉输氧的微流控装置。
DOI：
10.1073/pnas.2115276119
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发表时间：
2022-03-29
影响因子：
11.1
通讯作者：
Polizzotti, Brian D.
中科院分区：
文献类型：
--
作者：
Vutha, Ashwin Kumar;Patenaude, Ryan;Cole, Alexis;Kumar, Rajesh;Kheir, John N.;Polizzotti, Brian D.
低氧血症的治疗对目前的护理标准来说是难治性的，需要熟练的护理人员和使用专门的设备（例如，体外膜氧合）。大多数难治性低氧血症患者会出现器官功能障碍，死亡在该队列中很常见。在这里，我们描述了一种新的策略来稳定和支持患者使用微流体装置，管理氧气直接在实时和按需使用一个过程，我们称之为连续剪切诱导气泡破裂。如果成功，所描述的技术可能有助于避免或减少难治性低氧血症引起的呼吸机相关肺损伤的发生率。氧气在肺部被吸收，由血液携带，并被运送到组织中，在氧化磷酸化过程中，它作为终端电子受体。在健康期间，氧气供应充足；然而，COVID-19和许多其他形式的危重疾病会损害肺部并影响全身氧气输送。非常活跃的细胞不能忍受缺氧导致的能量生产不足。低氧血症即使持续几分钟，也会使一个健康的人变成终身神经系统受损的病人，当它难治性时，往往是致命的。在本文中，我们开发了一种通过静脉注射给病人氧气的方法，替代或补充受伤肺部的功能。在这里，我们展示了通过一系列依次减小尺寸的喷嘴将氧气和液体溶液混合在一起，我们能够根据需要实时制造比单个红细胞还小的氧气气泡。这些气泡被一层类似于身体其他细胞的“膜”覆盖，这1)防止它们与其他气泡合并形成更大的气泡，2)为氧气扩散到血液中提供了一条途径，3)将物质相关毒性的可能性降至最低。重要的是，这些设备使我们能够控制输送的氧气剂量和给药的液体量，这两者都是管理危重病人的关键参数。
The treatment of hypoxemia that is refractory to the current standard of care is time-sensitive and requires skilled caregivers and use of specialized equipment (e.g., extracorporeal membrane oxygenation). Most patients experiencing refractory hypoxemia will suffer organ dysfunction, and death is common in this cohort. Here, we describe a new strategy to stabilize and support patients using a microfluidic device that administers oxygen gas directly to the bloodstream in real time and on demand using a process that we call sequential shear-induced bubble breakup. If successful, the described technology may help to avoid or decrease the incidence of ventilator-related lung injury from refractory hypoxemia. Oxygen is picked up in the lungs, carried by the blood, and delivered to tissues where it serves as the terminal electron acceptor during oxidative phosphorylation. During health, oxygen is available in abundance; however, COVID-19 and many other forms of critical illness can damage the lungs and compromise systemic oxygen delivery. Cells that are very active cannot tolerate deficiencies in energy production that result from oxygen deprivation. Hypoxemia that lasts even a few minutes can turn a healthy person into a neurologically devastated patient for life, and when refractory it is often lethal. In this paper, we develop a way to administer oxygen gas to a patient through an intravenous line, replacing or supplementing the function of injured lungs. Here, we show that by coinfusing oxygen gas and a liquid solution through a series of sequential nozzles of decreasing size we are able to create bubbles of oxygen that are smaller than a single red blood cell on demand and in real time. These bubbles are coated with a “membrane” similar to that in every other cell in the body, which 1) prevents them from merging with other bubbles to create larger ones, 2) provides a path for oxygen to diffuse out and into the blood, and 3) minimizes the likelihood of material-related toxicities. Importantly, these devices allow us to control the dosage of oxygen delivered and the volume of fluid administered, both of which are critical parameters in the management of critically ill patients.
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影响因子：
10
作者：
Kheir, John N.;Polizzotti, Brian D.;McGowan, Francis X.
通讯作者：
McGowan, Francis X.
影响因子：
1.2
作者：
Thomson, Lindsay M.;Polizzotti, Brian D.;Kheir, John N.
通讯作者：
Kheir, John N.
影响因子：
9.9
作者：
Katiyar, Amit;Sarkar, Kausik
通讯作者：
Sarkar, Kausik
影响因子：
2.9
作者：
Sarkar, Kausik;Katiyar, Amit;Jain, Pankaj
通讯作者：
Jain, Pankaj
影响因子：
4.3
作者：
Peng，Yifeng;Kheir，John N.;Polizzotti，Brian D.
通讯作者：
Polizzotti，Brian D.